Feasibility of Implementing a National Corneal Transplant Registry: 2016 Update on the Ottawa Pilot Study

Abstract

Purpose : There are currently only three countries in the world with corneal transplant registries: Australia, Sweden, and India. The purpose of this study is to implement a Canadian Corneal Transplant Registry by conducting an initial pilot study on a smaller scale in the Ottawa region. The objective of the study was to collate information that will help Canadian corneal surgeons improve graft survival and increase transplant success. The 2016 update will review issues and challenges in setting up the registry.

Methods : Ethics approval for this study was obtained from the Ottawa Health Science Network Research Ethics Board. All patients who underwent a corneal transplant procedure between 2008 and 2016 at the University of Ottawa Eye Institute were included in this retrospective medical chart review and prospective case series study. Details of the donor graft, the procedure itself, indications for the transplantation, visual and surgical outcomes as well as post-operative complications were uploaded onto a de-identified online registry accessible to each participating corneal surgeon.

Results : 300 patients were included; the most prevalent procedures were Descemet’s Stripping Endothelial Keratoplasty/Descemet's Stripping Automated Endothelial Keratoplasty [156/300(52%)] and Penetrating Keratoplasty [93/300 (31%)]. The most common indications for transplantation were Pseudophakic Bullous Keratopathy [72/300 24%)] and Fuch’s Dystrophy [69/300 (23%)]. The overall incidence of graft failure was [60/300 (20%)]. Rejection and graft detachment lead to regrafting in (216/300 (72%)] of cases. The most common post-operative complications were elevated intraocular pressure in [63/300 (21%)] of cases and a loose or broken suture in [60/300 (20%)] of cases.

Conclusions : We believe that this registry captured the most valuable information for corneal transplant surgeons. This registry will help serve as the framework for a potential large-scale corneal transplant registry in Canada. Future directions for the study include recruiting corneal surgeons across Ontario and ultimately Canada to contribute to the registry.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.